Obsessive compulsive disorder, or OCD, is an anxiety disorder type of mental illness. Obsessive worry causes an individual to feel compelled to carry out rituals (compulsions). The term OCD is often thrown around when somebody likes to complete certain tasks a certain way, however; OCD is intrusive and effects the functioning of an individual’s everyday life. A client with OCD is often aware that their compulsions are negatively impacting on their life.

In the world of skin, clients often present to dermatologists with issues around hand washing and skin picking. In part one we will look at hand washing, and in part two, skin picking. Both of these problems can lead to serious infections, scarring and decreased self confidence.

Excessive hand washing

Excessive hand washing is an often seen in clients with OCD. They may spend a lot more time washing their hands than recommended or wash their hands more frequently than required. Our hands are pretty tough when it comes to skin: we even get an extra layer of skin here called the stratum lucidum.

Washing the skin excessively can cause a disruption to the skin’s natural barrier; being sloughed off by exfoliation and irritated by soaps. This combination of physical and chemical irritation causes a breakdown in the skin’s barrier and normal function, leading to redness, dryness, pain, dermatitis and infection.

Help is available for people with OCD. Cognitive behaviour therapy and Selective Serotonin Reuptake Inhibitors [SSRIs] have been shown to be effective for excessive hand washing and OCD. Changing the thought patterns and behaviours around hand washing can assist clients with OCD to reduce the impact that excessive hand washing has on their skin hygiene.

Professions where the ritual of hand washing is necessary- such as in the operating theatres- can also experience the symptoms of over washing. It is important that anyone who washes their hands more than the average person take extra care of the skin on their hands.

When should I wash my hands?

The World Health Organisation identifies that hand washing is the single most important step we can take to reduce the spread of germs and disease. However, over washing can cause harm to our hands. Here are some examples of when you would wash your hands for 15 seconds:

Before and after preparing a meal

Before eating a meal

Before and after touching an orifice or face

After using the toilet

After sneezing, coughing or whipping your nose

After handling money or contact with common surfaces

Before and after contact with animals

When your hands are visibly soiled

How to reduce irritation if you wash your hands frequently

If you have or know somebody with OCD, seek help from a trusted health professional. If you are struggling with excessive hand washing, you might need to see a dermatologist.

You should wash your hands with a pH friendly soap and reduce the use of antibacterials. The mechanical action of hand washing is enough to move germs off the skin. Other ingredients can also cause irritation to the skin, so find a wash that doesn’t contain sodium lauryl sulphate, parabens, mineral oils or fragrances.

Start by wetting your hands, and always use cool to lukewarm water: hot water dries out the skin, increasing irritation, dryness and redness. Wash your hands for a maximum of 20 seconds, excluding the time it takes to dispense and rinse the soap. Once you have finished, if your hands are dry, cracked or irritated moisturise your hands with a hand cream. Not only can dryness cause irritation and discomfort, but dryness contributes to the appearance of wrinkles.

Contact Us

If you have questions or require information about the dermatological consequences of excessive hand washing or obsessive compulsive disorder, contact your local doctor who will arrange for you to see a dermatologist.